A client is receiving an intravenous lidocaine infusion after being converted from ventricular tachycardia. The client begins to display signs of confusion, anxiety, agitation, and restlessness. What should the nurse do first?
1. Increase the rate of lidocaine infusion.
2. Turn off the lidocaine infusion.
3. Administer oxygen at 4 L per nasal cannula.
4. Notify the client's health care provider.
Correct Answer: 2
Rationale 1: Increasing the rate of lidocaine would worsen symptoms and could lead to ventricular dysrhythmia and subsequent cardiac arrest.
Rationale 2: The first signs of lidocaine toxicity usually involve the CNS and include confusion, anxiety, tremors, and other symptoms. The infusion should be discontinued immediately, and the health care provider notified.
Rationale 3: Oxygen should be administered, but this is not the first action the nurse should take.
Rationale 4: The health care provider should be notified, but this is not the first action the nurse should take.
Global Rationale: The first signs of lidocaine toxicity usually involve the CNS and include confusion, anxiety, tremors, and other symptoms. The infusion should be discontinued immediately, and the health care provider notified. Increasing the rate of lidocaine would worsen symptoms and could lead to ventricular dysrhythmia and subsequent cardiac arrest. Oxygen should be administered, but this is not the first action the nurse should take. The health care provider should be notified, but this is not the first action the nurse should take.
You might also like to view...
As long as the client is limiting her behaviors to verbal assaults and harmless physical movements,
1. she is placed in seclusion. 2. the acting out may continue. 3. the caregiver is prepared to apply restraints. 4. she is reminded of the inappropriateness of her behavior.
The family is concerned about the possibility of addiction due to the frequent doses of Roxanol. The nurse's best response is:
1. "At this stage, addiction is the least of our worries." 2. "This is a low-dose drug and controls pain without the problems of addiction." 3. "Addiction is rare, but we have drugs that can counteract the effect of this nar-cotic." 4. "You may want to share your concerns with the doctor. He can order another drug that is not addictive."
Which individual is at greatest risk for HIV/AIDS infection?
a. 34-year-old white woman who has received a blood transfusion b. 16-year-old black woman with one sexual partner c. 24-year-old white female who uses birth control pills d. 20-year-old white woman with past history of intravenous drug use
A 15-year-old girl is seen in the clinic because she has not yet had her first period. Which of the following questions would help the clinician determine the cause?
a. "Are you sexually active?" b. "How long have you been underweight?" c. "Did your mother take diethylstilbestrol during her pregnancy?" d. "Have you noticed any changes in your moods lately?"